One hundred ninety-five patients with end-stage knee osteoarthritis undergoing primary total knee arthroplasty were randomized to receive ACB + iPACK (n=65), ACB + PCI (n=65), or ACB alone (n=65). The primary outcomes were postoperative pain assessed by the Visual Analog Scale (VAS) and opioid consumption. Secondary outcomes included range of motion, Knee Society Scores (clinical and functional), Oxford Knee Score, and tolerance during continuous passive motion. Outcomes were evaluated at multiple intervals up to 12 weeks postoperatively. Overall, the results revealed that both ACB + iPACK and ACB + PCI significantly reduced VAS scores and opioid use during the first 12–48 hours compared to ACB alone, with no significant difference between iPACK and PCI. This suggests that PCI is not inferior to iPACK and may offer a simpler alternative for early pain management following TKA.